ASTHMA: What you need to know

Asthma is a chronic disease of the lungs that affects 7.5% of children in the United States. Patients with asthma develop swelling of their airway when faced with a variety of irritants or triggers. For many patients with asthma, a respiratory viral illness triggers their asthma causing trouble breathing and wheezing. Wheezing is the sound the air makes when it is forced through narrowed airways in the lungs. The novel coronavirus, SARS-COV2, can also trigger asthma, complicating the patient’s illness. While asthma is not curable, there are ways to control asthma. With the coronavirus pandemic going on, now is more important than ever to make sure your child’s asthma is controlled. Your CPCMG pediatrician is available to see your child either in the office or via Video Visit to make sure your child is up to date on their asthma medication.

How is asthma diagnosed?
Asthma is diagnosed in children over 3 years of age who have had multiple episodes of wheezing that is successfully treated with medication. Other symptoms of asthma include coughing, shortness of breath, and chest tightness. The medication used is called albuterol (brand names: Ventolin, Proair, Proventil) and is designed to relax the lungs and open the airway. This makes breathing return to normal.

What are the different classifications of asthma?
There are 4 different classifications of asthma, each representing different levels of severity. Many patients will move through these different classifications during their lifetime.

Mild Intermittent: This is asthma that occurs infrequently. Symptoms during the daytime are present less than 2 times per week. Nighttime awakenings occur less than 2 times per month.

Mild persistent: This is when asthma symptoms occur more than 2 times per week with nighttime awakenings occurring 3 to 4 times per month. Albuterol need or use is more frequent than intermittent asthma, more than 2 days per week but not daily.

Moderate persistent: This is asthma in which daily symptoms occur and nighttime awakenings due to asthma occurs more than once per week. Albuterol is needed more than 1 time per week.

Severe persistent: This is asthma that is so severe that daytime symptoms occur more than 2 times per week and nighttime awakening occurs more than 2 times per week. Sometimes the asthma is so severe that activity has to be limited.

What is the treatment for asthma?
There are two types of treatments for asthma. There is rescue, or acute, treatment for patients who are actively wheezing and there is control medication for persistent patients who require treatment to prevent symptoms.  It is very important for your child to use their medication properly. Most asthma medications come in the form of an inhaler, which needs to be used with a spacer to make sure they are receiving the medicine into their lungs.

Rescue inhaler (generic name: albuterol; brand names: Proair, Proventil, Ventolin): this inhaler is a short-acting medicine and usually helps your child within minutes. It lasts for up to 4 hours.

Controller inhaler: this inhaler is a long-term medication and helps prevent frequent asthma exacerbations if your child’s asthma is not well-controlled. The most common controller inhalers are Flovent and Qvar.

Is my child’s asthma well controlled?
To know if your child’s asthma is well controlled, use the Rule of “2”’s: daytime asthma symptoms less than 2 days per week, less than 2 nights per month, and needing their albuterol inhaler less than 2 days per week. If your child is not meeting the Rule of “2”’s, we recommend scheduling an office visit with your CPCMG pediatrician or nurse practitioner to see if your child may additional medicines to improve their symptoms.

How often should I follow up if my child has asthma?
It is important to follow up regularly if your child has asthma. At these visits, your CPCMG pediatrician will ask questions to see how well controlled your child’s asthma is and make sure that your child has enough refills for their inhalers. Your child may need additional medications or may be taken off existing medications depending on how well their asthma control is. Our typical follow up schedule at CPCMG is as follows:

• Acute asthma exacerbation: follow up in 1 week
• Mild intermittent asthma: follow up every 6-12 months
• Mild/moderate persistent asthma: follow up every 4 months
• Severe persistent asthma: may need to be managed by an allergy and asthma specialist

How can I schedule a follow up visit for asthma?
You may call your CPCMG pediatrician’s office to schedule an office visit or Video Visit for an asthma follow up appointment.